VBS Registration

June 13-17, 2022

9:00 AM – 12:00 PM

Ages: 2 Years Old – Entering 8th Grade

Please fill out one form for each child you’re registering.

Step 1 of 3 - Child's Information

Child's Name*

First Last

Date of Birth*

YYYY

Age*

Gender

Grade child will enter this fall*

Allergies

Anything else we should know about your child?

Parent/Guardian*

First Last

Phone Number (Text)*

Email Address*

Additional Parent/Guardian

First Last

Phone Number (Text)

Email Address

Emergency Contact

Emergency Contact (other than parent)

Phone Number

Person(s) allowed to pick up child other than parent(s)

Home Church

Sibling(s) Attending

List any siblings of this child that will be attending VBS. Please also submit registration forms for each additional child.

May we take pictures of your child to use on Holland's Facebook page & website?

Yes

May we take pictures of your child to use in slide presentations in our church?

Yes

This field is for validation purposes and should be left unchanged.

Holland Church